A Collaboration between Provincial Hospitals to Heal Broken Hearts

The unique collaboration between Cape Town’s Red Cross War Memorial Children’s Hospital (RCCH) and two government hospitals in the Eastern Cape has a long history.

For many decades, and certainly since long before democracy, specialist physicians and surgeons from Red Cross have been consulting with and treating new-born babies and older children in bi-annual clinics at Frere Hospital in downtown East London and Cecilia Makiwane Hospital (CMH) in Mdantsane about 25 km away.

It is a carryover from our country’s convoluted past – before 1994 when the cities were both part of the Cape Provincial Administration under the National Party government.

Ironically, under apartheid, CMH was technically excluded from the CPA because Mdantsane was located in what became the Ciskei bantustan under Lennox Sebe in 1981. CMH was formerly known as Mdantsane Hospital, being renamed in 1977 by the then Ciskei health minister Chief Mqalo in honour of the first black nurse to qualify in South Africa.

RCCH, now 61 years old, was started as a memorial to those who died in the second world war. Until Nelson Mandela Children’s Hospital was commissioned, it was the only hospital of its kind in sub-Saharan Africa.

Through the commitment of doctors and administrators and an agreement between the post-1994 provincial governments of the Eastern Cape and Western Cape, the work continues.

Twice a year, a team of paediatric cardiologists travels from Red Cross to do clinical assessments of children. These range from new-borns and very young children who have recently been diagnosed and referred by the resident paediatricians at the local hospitals, to older teenagers whose conditions were treated surgically in Cape Town many years ago and who come for annual check-ups.

In an emergency situation, Frere and CMH doctors will immediately refer a new-born with congenital heart disease for urgent treatment by the specialist cardiologists at RCCH.

These essential services and professional connections between the two centres are life-saving.

Over the years, hundreds of children from the eastern part of the Eastern Cape have been successfully treated in this collaboration. Says Frere Hospital paediatrician Maurice Levy: “There are very few congenital heart defects which are not correctable, but they should be detected early”.

RCCH paediatric cardiologist George Comitis says that while there are no new pathologies or variations in disease, “there are always new challenges and new intervention techniques” either in surgical theatres or the cathlab.

Watching the visiting doctors and their hosts interact with their young patients is inspiring. The children are examined in tandem in adjacent beds in a ward filled with files and pieces of electronic equipment. There is close communication between the doctors, the child and the parent during the process; from time to time, the doctors will “cross-examine” each other’s patient as a second opinion is sought on a scan image or x-ray. Junior doctors and interns both contribute during assessments and gain valuable knowledge as well.

Mothers of new patients, perhaps not able to fully control the emotional upwelling that comes from confirmation their child has a heart condition which requires surgery in Cape Town, are comforted in an environment that quietly shouts out “we’re in this with you, it’s all going to be okay in time”.

At the right time, RCCH facilitates transport of the mother-and-child from the Eastern Cape to Cape Town and also provides accommodation for the mother for the time the child is admitted. The hospital also has a teacher on its team who assists its young patients to keep up with their studies while away from school. Reports are even provided to the school the child usually attends.

The facility does about 450 corrective procedures on children each year, of which more than two-thirds are surgical lists.

“We need a children’s hospital in each of the other provinces too,” says paediatric cardiologist and director of the cardiac catherization laboratory (cathlab) at Red Cross, Dr Rik de Decker.